A mathematical model of COVID-19 transmission in a tertiary hospital and assessment of the effects of different intervention strategies

PLoS One. 2020 Oct 26;15(10):e0241169. doi: 10.1371/journal.pone.0241169. eCollection 2020.

Abstract

Novel coronavirus (named SARS-CoV-2) can spread widely in confined settings including hospitals, cruise ships, prisons, and places of worship. In particular, a healthcare-associated outbreak could become the epicenter of coronavirus disease (COVID-19). This study aimed to evaluate the effects of different intervention strategies on the hospital outbreak within a tertiary hospital. A mathematical model was developed for the COVID-19 transmission within a 2500-bed tertiary hospital of South Korea. The SEIR (susceptible-exposed-infectious-recovered) model with a compartment of doctor, nurse, patient, and caregiver was constructed. The effects of different intervention strategies such as front door screening, quarantine unit for newly admitted patients, early testing of suspected infected people, and personal protective equipment for both medical staff and visitors were evaluated. The model suggested that the early testing (within eight hours) of infected cases and monitoring the quarantine ward for newly hospitalized patients are effective measures for decreasing the incidence of COVID-19 within a hospital (81.3% and 70% decrease of number of incident cases, respectively, during 60 days). Front door screening for detecting suspected cases had only 42% effectiveness. Screening for prohibiting the admission of COVID-19 patients was more effective than the measures for patients before emergency room or outpatient clinic. This model suggests that under the assumed conditions, some effective measures have a great influence on the incidence of COVID-19 within a hospital. The implementation of the preventive measures could reduce the size of a hospital outbreak.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • COVID-19 Testing
  • Caregivers
  • Clinical Laboratory Techniques
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / transmission*
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control
  • Cross Infection / transmission*
  • Early Diagnosis
  • Emergency Service, Hospital
  • Hospital Departments
  • Humans
  • Incidence
  • Infection Control / methods*
  • Mass Screening
  • Medical Staff, Hospital
  • Models, Theoretical*
  • Nursing Staff, Hospital
  • Outpatient Clinics, Hospital
  • Pandemics* / prevention & control
  • Patients
  • Patients' Rooms
  • Personal Protective Equipment
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / transmission*
  • Republic of Korea / epidemiology
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Symptom Assessment
  • Tertiary Care Centers*
  • Visitors to Patients

Grants and funding

This work of Jun Yong Choi was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention [2019-ER5408-00], research grants for deriving the major clinical and epidemiological indicators of people with HIV [Korea HIV/AIDS Cohort Study, 2019-ER5101-00], and a grant from the Ministry of Health & Welfare, Republic of Korea [grant number: HI14C1324] The work of Jeehyun Lee was supported by National Research Foundation of Korea [grant number: 2020R1A2C1A0101077511] and Korea Health Industry Development Institute [grant number: HG20C0003030020].